NPIMap

Kenneth Bernard Chase, DDS

Individual provider Active NPI General Practice Dentistry · Leonardtown, MD

NPI 1306069240 · NPPES record last updated Sep 23, 2016

Key facts

NPI
1306069240
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6787 (MD)
Practice address
23808 Hollywood Road
Leonardtown, MD 20650
Phone
(301) 475-5926
Fax
(301) 475-5971
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

  • Drkbchasellc General Practice Dentistry · Leonardtown, MD · NPI 1912221649
    NPD GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6787MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Drkbchasellc General Practice Current Accepting new patients

Locations

23808 Hollywood Rd
Leonardtown, MD 20650
Phone (301) 475-5926

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6787 MD Yes

Addresses

Primary practice location

23808 Hollywood Road
Leonardtown, MD 20650

Mailing address

23808 Hollywood Road
Leonardtown, MD 20650
Phone (301) 475-5926

Other providers in Leonardtown, MD

All providers in Leonardtown, MD · General Practice Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.